Can your overseas medical degree help you climb the UK career ladder?

by     11 Comments    Posted under: Career, International

Can I make it in my chosen specialty in the UK with an overseas degree? Doesn’t the NHS just look after its own?

This is a common question i’m getting asked lately. It seems to originate from two groups of people.

There are those that are are already at, or about to start at an overseas medical school and are worried that moving to the UK might not afford them the same career opportunities as it does for local UK graduates.

A second group of individuals are worried that they may not make the cut for medicine this year and are thinking about taking up an expensive place at an overseas medical school. Commonly this might be in the Czech Republic, Romania, the West Indies but also elsewhere.

Let me start by saying something a little controversial.

The NHS has historically discriminated against foreign medical graduates whenever it has found itself in a comfortable enough position to do so.

This situation does not commonly arise and certainly woud be unlikely to apply to all areas.

So to a large extent it depends on what you want to do and the current job situation within the NHS.

To explain this, let me give you a bit of useful background that you should already be aware of.

In the 1960s plenty of consultant and GP posts were taken up by foreign graduates who had been encouraged to the UK and had also done most of their postgraduate training overseas. The UK was desperate for doctors due to a major shortage and there were plenty of them arriving from Indian and Pakistan. These were deemed to be of exemplary quality by none other than Enoch Powell who lead the call for overseas recruitment.


Well you see, the UK repeatedly gets its medical workforce planning terribly wrong due to perennial political interference. The shortage of the 1960’s happened because of a planned cut in medical school places by the Willink Committee of 1957 along with vast numbers of British doctors emigrating to find better conditions in the US and elsewhere.

By the 1990s however, graduates from India and Pakistan as well as other less well off countries suddenly found it much more difficult to climb the career ladder and find suitable specialist posts.

There were accusations of discrimination from well qualified foreign specialists who found themselves stuck in staff grade posts with no clear route to consultant jobs which often seemed suspiciously reserved for British graduates.

Clearly there were more local graduates in the pool now and the NHS could now afford to pick and flick accordingly.

By 2005 disillusioned foreign doctors in some specialities were already leaving after realising that the path ahead was pretty well blocked for them in the UK. Even UK graduates found that competition in some specialities, particularly surgery had stiffened with tens of applicants per post. Many left for Australia and many abandoned their hopes of ever getting ahead in their first choice specialities.

Of course those who set their goals elsewhere may not have noticed the change and in the world of pathology and psychiatry there was an ongoing recruitment drive that also helped mop up the fall out from more competitive areas.

That’s a long winded way of saying that you can’t trust the system to always help you out paticularly if you’re aiming for something competitive or lucrative in the long run.

For example, who knows whether dermatology will be as competitive as it is today in five or ten years time when you are finally applying for specialist posts. If it is, you may find that a foreign degree is indeed a disadvantage and you will need to show a more bejewelled CV to muscle past the local favorites.

However most applicants to medical school are just happy to get a place and to have a shot at becoming a doctor at the end of the process. If the speciality and the region in which you end up are not critical you probably* should not be worried.

How to ignore the above and rise above the competition
My final advice to anyone with an overseas medical school education and a firm desire to work in a competitive area in the UK would be to start sorting your CV out early.

If you have two original papers in the BMJ and a review article published in the lead speciality journal for your intended area of interest, you stand an excellent chance of getting through. Those are difficult things to get done and will take months and years to accomplish. Consequently they carry great weight and will eat up the competition. The majority of UK graduates at present leave medical school with a CV that may as well be blank when it comes to postgraduate competitiveness.

So, decide what you want to do early, and make contacts in the relevant fields. They will give you research ideas and guidance.

On the other hand if you’re sure you’d be happy as a salaried GP in a small town far away from London, relax, enjoy the sun (yes, SGU Carribean) and work on your golf swing.

And don’t fail finals.

*Unless a policy maker somewhere really screws it up. This is common.

11 Comments + Add Comment

  • A large number of this years premed cohort at my sixth form have had a complete ucas wipeout wiyh rejection from all med schools.
    A few if us are thinking of reapplying next year but six years of med school in prague is an option and sounds good to me.
    This article worries me a little though. Is there really such a difference in success rates and do you recommend decking out my cv from day 1??

    How would i go about doing this?

    • Speaking to people that have done this, six years in Prague (if you can afford the fees) can be great fun and gets you out of the UK / London mindset for a while which can be refreshing.

      Equally taking a year out and reapplying in the UK should be successful provided you follow the right advice.

      In terms of decking out the CV, you are right: do it from day 1.

      The maxim is to publish everything you ever write at medical school. If you have a research paper to write, look at the current literature and make sure your project adds to it and is written up to an adequate standard.

      This does not actually take any extra time as you’re having to write the damn thing anyway!

      You should get supervisor support and guidance as soon as they know you are aiming to publish – it’s a free paper for them!

  • What about the US? I know plenty of UK grads want to work in th eUS as the postgraduate training is shorter and better.
    What about US graduates wanting to work in the UK? DO they face the same issues or is a US medical degree more respected?


    • Good question.

      Compared to other internationals, a US graduate is probably more respected in the UK, particularly if you come from Ivy league territory. However in competitive areas I find UK graduates are still given preference in the absence of the so called ‘killer CV’ as described in the article. Given the excellent training in the US, few actually move to the UK.

      UK graduates going to the US can face an uphill struggle, again highly dependent on specialty and geography. I have plenty of colleagues who have made the move with ease and are doing psychiatry in Kentucky or internal medicine somewhere south but have yet to meet someone doing plastic surgery in NYC. You get the idea.

      We are researching an article on this very issue which should appear soon.

  • Let us not forget that there is near zero unemployment among doctors in general and there remains healthy recruitment of overseas doctors.

    This article only concerns those who have very specific career plans and need to get out and compete.

    The only concern an overseas degree should raise is about the quality of teaching and training.

  • Comment removed

  • Working on my golf swing sounds good thanks!

    I personally don’t have any major career ambitions. Just graduating as a doc is good enough. For those prepared to innovate, medicine should offer plenty of career opps away from the rat race!

  • What about PLAB.?
    Is it difficult?

  • Plab is easy!
    Can you speak english? That’s the bit some people fall down on.

    We’ll do a quick guide to PLAB soon to help you kill it in one quick shot.

  • I must first of all acknowledge the efforts of Admin to make it an informative forum. I am not sure whether it is the right forum to put forth my query on, i hope i will be excused.
    I am a doctor in India and have done my MD (post-graduation) in Internal Medicine from India only. Presently I am working as a consultant in a renowned hospital. I am interested in shaping a career in Rheumatology, and am thinking of pursuing a Fellowship in UK. Do I need to get an MRCP first, or do I have to clear PLAB? I am more interested in just getting quality training in the field and wish to come back to India after that.
    It would be great if you could guide or post some links.
    Thanks and keep up the great work.

    • Hi,

      You have to get the PLAB cleared to work in the UK and MRCP to progress towards getting a consultant post.
      However, if you’re simply looking at fellowships and intend to practice in India, I’m sure some fellowships will not require MRCP if you already have completed similar training in India and observational fellowships may not even require PLAB.
      It’s best to apply for individual fellowships you’re interested in and and ask.